Refund of money for treatment: how to recover payment from a clinic in Kazakhstan

Clients face a situation where payment has been made but the result has not been obtained more often than it seems: an appointment was postponed, the treatment plan was changed, the service turned out to be unnecessary or was performed only in part. From that moment the conversation about a refund of money for treatment begins, and the first thing to understand is which rule to base the demand on and how to confirm the very fact of payment.

Usually people come to us after the clinic has refused orally or stopped responding. Below is the sequence of steps: from analysing the contract and payment documents to a claim, a court claim and enforcement proceedings. The specifics where the payer is an entrepreneur are considered separately, along with typical mistakes that delay recovery.

Refund of money for treatment: when the clinic is obliged to return the payment

The right to a refund of payment for medical services arises when the clinic has not provided the service or has provided it not in the volume agreed with the patient or the customer. The basis is the Code of the Republic of Kazakhstan on Public Health and the Healthcare System and the provisions on paid provision of services in the Civil Code of the Republic of Kazakhstan. The same act obliges the medical organisation to provide quality care in the agreed volume.

Situations of refund of money for treatment are connected with the fact that the service was not started, was performed in part, or the result does not correspond to what was agreed. If the service was not provided but the payment went through, the customer is entitled to demand a refund of the amount. A refund is also possible where the patient refuses the service before it is actually provided — taking into account the expenses actually incurred by the clinic.

Refund of money for treatment: the contract with the clinic as the basis of the demand

Paid medical services are provided under a contract for the provision of services for consideration, governed by the Civil Code of the Republic of Kazakhstan and the Law of the Republic of Kazakhstan "On Protection of Consumer Rights". The contract records which procedures and in what scope the clinic undertook to perform, and the patient undertook to pay for them. Without a written contract and confirmation of payment, it is more difficult to demand a refund, so keep the signed copy, invoices and receipts.

A refund depends on the agreed terms: the subject matter and scope of services, the payment procedure, the timeframes, and the section on amendment and termination. If the contract sets out the conditions for a refund upon refusal of procedures, the clinic is guided by them, and not by its internal rules.

• Subject matter of the contract: the specific medical services and procedures that the clinic undertakes to provide.
• Scope and timeframes for the provision of services: the list of procedures, their number and the period for performance.
• Payment procedure: advance payment, instalments, stages of payment and documents confirming payment.
• Terms for amending the contract: how additional procedures and adjustments to the scope are agreed.
• Terms for termination and refund: the grounds for refusing services and the procedure for calculating the unused amount.
• Liability of the parties: the consequences of breach of timeframes and of the quality of the medical services provided.

Refund for treatment: payment is confirmed — what next

Payment for treatment is confirmed by primary documents, and it is these that determine whether the patient will be able to get the money back. The fact of payment is proved by specific papers: written evidence issued by the clinic or the bank. The more complete the set, the fewer disputes about the very fact of payment.

The main document is the cash receipt for payment of medical services: it records the amount, date and recipient of the payment. If payment was made through a bank, it is confirmed by a payment order and a bank account statement. When paying in cash at the cash desk, a receipt to the cash payment order or another strict reporting form is issued.

• cash receipt issued upon payment at the clinic's cash desk
• receipt to the cash payment order for cash payment
• payment order for non-cash transfer
• bank account statement of the payer
• clinic's certificate of payment for medical services
• documents of the payer, if the treatment was paid for by a relative

Refund for treatment: types of claims and their differences

Paid medical services fall under the Law of the Republic of Kazakhstan "On Protection of Consumer Rights", so the patient is entitled to choose between several claims against the clinic, and not only to raise the question of a refund for treatment. Each claim has its own legal nature and consequences, and they cannot be arbitrarily mixed in one claim. Below is a description of how the main types of claims differ.

Refund of the unearned advance — recovery of the amount paid for a service that was in fact not provided. It is appropriate when treatment has not begun, was interrupted at the clinic's initiative, or the clinic has not performed the agreed scope. A reduction in the cost of treatment applies when the service was provided, but its quality or scope does not correspond to the contract: the price is reduced in proportion to the defects. Reimbursement of expenses for remedying defects — compensation of the costs incurred by the patient to correct the consequences of a poor-quality service with another specialist. Compensation for harm to health — a separate claim related to bodily injury and other consequences for the body; it does not come down to a refund of the amounts paid. All claims may be made both separately and in combination, if the grounds coincide. The types of claims against the clinic differ in the subject matter of proof and the legal result:

• refund of the unearned advance — recovery of what was paid for a service not provided;
• reduction in the cost of treatment — a proportionate reduction in price where the service provided has defects;
• reimbursement of treatment expenses — compensation of the costs of remedying defects with third parties;
• compensation for harm to health — compensation for consequences for the body, including lost earnings and additional expenses;
• remedying defects by the clinic — free repeated provision of the service where correction is possible;
• withdrawal from the contract — termination of obligations with a refund of the unworked portion of the payment.

The claims may be combined if the relevant grounds are confirmed.

Refund of money for treatment: pre-trial claim to the clinic

A claim to the clinic is the first step in the pre-trial refund of money for treatment. The document is addressed to the head of the medical organisation — the clinic, centre, office or LLP where the service was provided. If the assistance was provided by a doctor as an individual entrepreneur, the claim is submitted to him personally.

The claim is drawn up in writing: details of the patient and the representative, information about the service provider, a description of the circumstances and services, an indication of the defects or withdrawal from the service. Then — a demand for a full or partial refund of the payment with the method of transfer, a reference to the provisions of the Code and the contract, if one was concluded.

• a copy of the contract for the provision of medical services
• payment documents confirming payment for treatment
• medical documents confirming the scope and nature of the assistance
• a power of attorney, if a representative of the patient is acting
• correspondence with the clinic and other evidence of the request
• calculation of the amount to be refunded

Payment in itself does not yet prove that the service was provided. Until the clinic provides confirmation of the scope and quality, the claim for a refund remains justified.

Refund for treatment: the clinic's response and refusal

Paid medical services are covered by the Law of the Republic of Kazakhstan on Consumer Protection: the clinic is responsible for the quality and scope of care. If the treatment produced no result or was interrupted, the refund depends on what was done under the contract and whether actual costs were incurred.

Most often the clinic refuses, citing services actually provided: consultation, diagnostics, procedures. This argument holds only where the result is confirmed by medical documentation, not by a price list or the words of an administrator.

Another ground is that the patient interrupted the treatment on their own initiative. Here it is important to separate the completed scope from payment for stages not carried out: a refusal to refund for services not provided is unfounded, even if the contract is terminated at the patient's request.

• the refusal repeats general wording without reference to specific services provided
• the clinic's response to the claim contains no calculation of the amount withheld
• services not provided are included in the total cost of the course
• the costs are not confirmed by documents or relate to other patients
• the clinic relies on a no-refund clause in case of refusal of treatment, although such a clause infringes consumer rights
• there is no reference to the Law of the Republic of Kazakhstan on Consumer Protection

Refund for treatment: where to file a claim and how to calculate time limits

A dispute over a refund for treatment is heard by a court under the rules of civil proceedings. The claim is filed at the location of the defendant — the clinic; if the dispute arises from the activity of a branch, the claim may be filed at the location of the branch. Claims for consumer protection may also be filed at the claimant's place of residence under the Civil Procedure Code of the Republic of Kazakhstan. Such disputes are heard by a district (city) court.

Pre-trial settlement in such disputes is not mandatory, but a written claim records the position and the date from which time limits begin. The claim is filed in writing under the rules of the Civil Procedure Code of the Republic of Kazakhstan, with the contract, payment and medical documents attached.

• Identify the defendant: the clinic, a branch or a specific medical professional.
• File the claim at the location of the clinic or at your own place of residence — in consumer protection disputes the choice is the claimant's.
• Attach the contract, receipts and medical documents to the statement of claim.
• A patient's claim against a clinic is heard by a district (city) court regardless of the amount.
• Observe the limitation period and record the date when you learned of the infringement of your right.
• Obtain the writ of execution and pass it to the court enforcement officer after the judgment enters into force.

Refund for treatment: evidence in a civil case

A dispute over a refund for treatment is based on written and physical evidence. Paid medical services are covered by the Law of the Republic of Kazakhstan on Consumer Protection, so as a general rule the burden of proving that the service was provided with quality and in full lies with the clinic. What matters to the court are documents on the agreement of the service, its payment and its performance.

The basis of proof consists of the contract for paid medical services, payment documents and medical documentation. Correspondence with the clinic, including electronic messages, confirms the agreement of terms and the patient's claims. Where a service not provided is to be confirmed, the entries in the medical record, the procedures actually carried out and the paid scope are compared.

• contract for the provision of paid medical services
• payment documents: receipts, payment slips, statements
• medical records: patient card, prescriptions, reports
• correspondence with the clinic, including electronic messages
• independent expert report
• witness testimony

Refund of money for treatment: enforcement proceedings in Kazakhstan

After the court grants the claim for a refund of money for treatment, the claimant is issued a writ of execution. It confirms the right to enforce recovery from the clinic and is submitted at the place of its location or the location of its property. The period for submitting the writ is limited, so it is not worth delaying its receipt and dispatch.

Enforcement of court acts in such cases is carried out by private court enforcement officers. The claimant chooses a private court enforcement officer at the place of location of the clinic or its property and submits an application to them, attaching the writ of execution and the bank details for the transfer of sums.

• obtaining the writ of execution in court
• choosing a private court enforcement officer at the place of location of the clinic or its property
• filing an application to initiate enforcement proceedings
• requesting information on the clinic's accounts and property
• seizure and recovery against monetary funds
• monitoring the completeness and timing of enforcement

Refund of money for treatment: specifics for a business

When treatment is paid for by an LLP or an individual entrepreneur, the refund of money is based not only on the Law of the Republic of Kazakhstan on the Protection of Consumer Rights. The parties to the contract are the clinic and the organisation, while the employee or director is the beneficiary, so the claim for a refund of payment under the invoice is made by the payer, not the patient.

A contract with a clinic concluded by a legal entity is formalised with an invoice for payment and an act of services rendered. If the service was not provided, was provided poorly, or was paid for twice, the company sends a pre-action claim based on the contract, invoice and payment order for the bank transfer. The refund requires formalisation: the money is credited to the payer's account, and the parties sign a termination agreement or an adjustment act. This is important for accounting and tax records. Corporate expenses on treatment are confirmed by the contract, invoice, act and payment documents.

• Check who is stated as the payer in the contract and invoice: an LLP, an individual entrepreneur or an employee.
• Keep the originals of the contract, invoice, act and payment order.
• Record exactly which service was not provided or was provided with defects.
• Send the clinic a written pre-action claim demanding a refund of the sum.
• On refund, formalise a settlement agreement and adjustment documents.
• Account for the refunded sums in accounting and tax records.

Refund of money for treatment: five mistakes that hinder recovery

In reviewing the practice of recovering money for treatment, five mistakes most often stand in the way of recovery. The absence of a written contract with the clinic does not deprive the patient of protection, but it complicates recovery: the provision of services and their terms have to be proven.

Mistakes in recovering payment are usually connected with documents and deadlines. Payment without a receipt, a voucher or a card statement turns the dispute into a question of whether the money was actually handed over. Failure to record claims — not being given a copy of the contract, the absence of written demands and of the clinic's replies — deprives the patient's position of evidence. Missing the deadlines set for the protection of a violated right means the claim is dismissed even if the demands are well-founded, while going to court without a pre-trial claim closes off the possibility of settling the dispute without proceedings.

• There is no written contract — the terms of the services and their scope have to be proven by circumstantial evidence.
• Payment without a cash receipt, a voucher or a bank statement — it is difficult to confirm the amount paid.
• Claims are not recorded in writing — there is no evidence of contacting the clinic before court.
• The deadline for protecting the violated right has been missed — the court dismisses the claim regardless of whether the demands are well-founded.
• The claim was filed without a pre-trial claim — the possibility of settling the dispute without court proceedings is lost.

The table does not replace an assessment of the specific situation: what matters is which documents have been preserved and when the patient learned of the violation of their right.